A significant part of the solution is for front line staff to own the solution. This can be done by facilitating ideas generation and definition of processes by them (not for them).

I have a couple of case studies that may be of interest to you:

www.medmosaic.co.uk/casestudy/realising-im-t-enabled-service-and-cost-improvements.html

www.medmosaic.co.uk/casestudy/birmingham-children-s-hospital-ft.html

Steve

"business case", "options appraisal", "clinical information strategy" - I agree they are not terms that most front line staff get excited about and therefore don't tend to commit requirements to paper. However, they will talk to us and we can commit their requirements to paper. It's about talking to them on their own terms (in their workplace even) and capturing their thoughts. It's then the job of Health Informatics staff to turn that into requirements.

As an erstwhile clinician (..yawn..) I'd say it's because the language of 'business' is anathema to most clinicians. Most of us came into health because of a general antithesis to 'business interests' if you like (what did I do with my LPYS membership?). This is really semantics though. So often people split off 'business' from 'clinical' - we are in the clinical business though aren't we?

One of the tasks of the British National Formulary team is to explain the benefit of using our new digital products in a way that makes sense to the professional groups we serve. Don't you think that suppliers addressing end users is one way of building up a good picture of what can be done, what benefits accrue, etc? All IT or information suppliers employ clinicians and professionals to do just this. On such understanding business cases can be built.